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Interventricular Septum Hydatid Cyst: Successful Seven-Year Follow Up- Case Report
Asadollah Mirzaie1, Majid Reza Erfanian-Taghvaei2, Maryam Mirzaie3
11. Dept. of Cardiac Surgery, Mashhad University of Medical Sciences , Mashhad, Iran.
Insights
Hydatid cyst disease, a parasitic infection, can present with vague symptoms and requires consideration in endemic areas. This case highlights cardiac echinococcosis in a young patient, emphasizing its importance in differential diagnosis.
Area of Science:
- Parasitology
- Cardiology
- Infectious Diseases
Background:
- Hydatid cyst disease (echinococcosis) presents with non-specific symptoms, often requiring broad differential diagnosis in endemic regions.
- Cardiac involvement is rare, accounting for <2% of all hydatid disease cases, but should be suspected in patients with a history of the disease.
Purpose of the Study:
- To report a rare case of primary cardiac echinococcosis in a pediatric patient.
- To emphasize the importance of considering cardiac echinococcosis in the differential diagnosis of unexplained cardiac masses, especially in endemic areas.
Main Methods:
- A 14-year-old male presented with right lower extremity artery occlusion.
- Surgical exploration revealed multiple hydatid cysts in the femoral artery.
- Echocardiography identified a mobile mass in the interventricular septum, which was surgically resected.
- Histopathological examination confirmed a complicated hydatid cyst.
Main Results:
- Complete surgical resection of the cardiac hydatid cyst was achieved.
- The patient remained recurrence-free during a 7-year clinical and serological follow-up.
- The initial presentation mimicked peripheral arterial disease due to disseminated hydatid cysts.
Conclusions:
- Primary cardiac echinococcosis is a rare but significant consideration in endemic countries, even with initial peripheral manifestations.
- Early diagnosis and complete surgical excision are crucial for favorable outcomes.
- Long-term follow-up is essential to ensure no recurrence of hydatid disease.
Abstract:
Hydatid cyst disease should be considered in differential diagnosis in many doubtful clinical situations as can present with non-specific symptoms especially in the endemic areas. Cardiac involvement should be considered in patients with history of previous hydatid cyst disease.. Cardiac hydatid cysts account for less than 2% of all hydatid diseases. In this report we aimed to present a case of 14-year-old boy with the diagnosis of occlusion of artery of the right lower extremity. Surgical exploration of the femoral artery revealed multiple hydatid cysts. Echocardiography showed a mobile mixed mass lesion. Complete resection of the mass was done from interventricular septum. Histo-pathological examination of the removed tissue revealed a complicated hydatid cyst and complete mass excision was confirmed. In this case a 7 year clinical and serological tests evaluation follow-up after surgical treatment showed no evidence of recurrence. The finding of this case emphasizes that in endemic countries, primary cardiovascular echino-coccosis should be considered in differential diagnosis.
